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A rare form of blood cancer

Hepatic encephalopathy (HE) is a serious and potentially life-threatening condition that occurs when the liver can no longer remove toxins from the blood, especially ammonia produced in the intestines. When these toxins build up, they impair brain function. Without prompt treatment, HE can progress to coma or death. HE most often develops in people with advanced liver disease, particularly cirrhosis, but it can also occur with acute liver failure, liver cancer, or after certain liver procedures. It affects 30–40% of people with cirrhosis. Alcohol use, infections, medications, internal bleeding, and blood flow abnormalities can trigger episodes. ⚠️ HE is a medical emergency. Sudden confusion, extreme sleepiness, or unresponsiveness requires immediate emergency care. Types of Hepatic Encephalopathy Type A: Caused by acute liver failure, developing rapidly over days or weeks Type B: Caused by abnormal blood flow (portosystemic shunts) that bypasses the liver Type C: Occurs in people with cirrhosis or acute-on-chronic liver failure HE may be: Overt: Symptoms are clearly noticeable Covert: Subtle cognitive changes detectable only with testing Symptoms Difficulty concentrating or confusion Disorientation (not knowing where you are) Daytime sleepiness or insomnia Memory problems Flapping hand tremor (asterixis) Personality or mood changes Slurred speech or poor coordination Coma in severe cases These symptoms can significantly reduce quality of life and daily functioning. Causes and Triggers Liver failure or cirrhosis Alcohol use Infections Gastrointestinal bleeding Electrolyte imbalances (low sodium or potassium) Dehydration or constipation Certain medications (sedatives, opioids, diuretics) Complications after liver transplant Risk Factors Advanced liver disease Diabetes or kidney disease Older age Low muscle mass (sarcopenia) High blood ammonia levels Alcohol use Poor nutrition Possible Complications Falls and injuries Long-term memory and attention problems Driving impairment Frequent hospitalizations Coma Death Prevention You can lower the risk of HE by: Taking medications exactly as prescribed Eating plant-based and dairy protein instead of excessive animal protein Avoiding alcohol, sedatives, and opioids Staying well hydrated Preventing constipation Treating infections promptly Attending regular liver checkups Early recognition and treatment of hepatic encephalopathy can be lifesaving. If you or someone with liver disease develops sudden mental changes, seek emergency medical care immediately.

What Is Carotid Artery Stenosis? Carotid artery stenosis, also called carotid artery disease, is a condition in which the carotid arteries become narrowed. These arteries run along both sides of the neck and are responsible for supplying oxygen-rich blood to the brain. The narrowing occurs due to the buildup of plaque, a mixture of fat, cholesterol, calcium and other substances found in the blood. Over time, plaque accumulation restricts blood flow to the brain. Carotid artery stenosis is a serious condition because: Severely reduced blood flow can deprive the brain of oxygen A piece of plaque can break off and travel to the brain Blood clots may form and block brain arteries All of these situations can result in a stroke, which can cause permanent disability or death. What Are the Symptoms of Carotid Artery Stenosis? Most people with carotid artery stenosis do not experience symptoms until the artery becomes severely narrowed. In many cases, the first sign of carotid artery stenosis is a stroke or a transient ischemic attack (TIA), often referred to as a “mini-stroke.” A TIA produces stroke-like symptoms, but they: Last only a few minutes Usually resolve within an hour Serve as a serious warning sign of a future stroke Symptoms of Stroke or TIA Seek emergency medical attention immediately if any of the following occur: Sudden numbness or weakness on one side of the face or body Difficulty speaking or slurred speech Dizziness, loss of balance, or trouble walking Sudden vision loss or blurred vision in one or both eyes Severe headache with no known cause What Causes Carotid Artery Stenosis? The primary cause of carotid artery stenosis is atherosclerosis. Atherosclerosis is a gradual process in which plaque builds up along the inner walls of the arteries, causing them to: Narrow Harden Lose flexibility As the carotid arteries narrow, less blood reaches the brain. In some cases, plaque can rupture, allowing fragments to travel through the bloodstream and block smaller arteries in the brain, triggering a stroke. Risk Factors for Carotid Artery Stenosis Several factors increase the likelihood of developing carotid artery stenosis: High blood pressure (hypertension) – weakens artery walls Smoking – damages artery lining and raises blood pressure Sedentary lifestyle – increases risk of obesity, diabetes and hypertension High cholesterol levels – promotes plaque formation Diabetes – impairs fat metabolism and accelerates atherosclerosis Obesity – increases risk of cardiovascular disease Advancing age – arteries naturally lose elasticity over time Family history – higher risk if close relatives have atherosclerosis or heart disease Complications and Related Conditions If left untreated, carotid artery stenosis can lead to: Ischemic stroke due to blocked blood flow Transient ischemic attacks (TIAs) Permanent neurological damage Disability Death Stroke is the most serious complication and may result from: Reduced blood flow Plaque rupture Formation of blood clots How Can Carotid Artery Stenosis Be Prevented? Prevention focuses on managing modifiable risk factors through lifestyle and medical interventions: Quit smoking and avoid tobacco products Exercise regularly Maintain a healthy weight Follow a heart-healthy diet rich in fruits, vegetables and whole grains Limit salt, saturated fats and processed foods Control blood pressure, cholesterol and blood sugar levels Take prescribed medications as directed Attend regular medical check-ups